白内障超声乳化术后黄斑中心凹厚度及视网膜敏感度变化相关研究
发布时间：2018-08-12 19:45
【摘要】：第一部分单纯老年性白内障超声乳化术后黄斑中心凹视网膜厚度及视网膜敏感度变化 目的：观察单纯老年性白内障患者在超声乳化吸除术后黄斑中心凹厚度以及视功能变化情况,探讨黄斑结构变化与视功能之间关系。 方法：使用光学相干断层扫描(Optical Coherence Tomography, OCT)联合微视野仪(Microperimetry-1,MP-1)对128例单纯老年性白内障患者在超声乳化吸除术前、术后1周、术后1月以及术后3月进行检查,观察患者术眼黄斑中心凹厚度(Foveal Thickness, FT),黄斑中心10°范围视网膜平均光敏感度(MeanSensitivity, MS)以及最佳矫正视力(Best Corrected Visual Acuity,BCVA)的变化,分析超声乳化术对视网膜厚度影响。 结果：128例单纯老年性白内障患者OCT检查术前平均FT为231.7±8.4μm,术后1月为234.3±18.2μm,术后1月较术前有显著性差异,P0.05；术后3月平均FT较术前无统计学差异,P0.05。MP-1检测术前平均MS为9.7±3.3dB,术后1月为15.1±4.5dB,术后1月较术前有显著差异P0.05。术前BCVA0.3的患者有51例,0.4～0.6的患者77例,术前平均LogMAR BCVA为0.43±0.22,术后1月时BCVA在0.4～0.6患者20例,≥0.7的患者108例,术后1月平均LogMAR BCVA为0.11±0.13,术后1月较术前有显著性差异,P0.05。 结论：白内障超声乳化吸除并人工晶体植入术对单纯老年性白内障患者眼底影响小,术后视网膜光敏感度和最佳矫正视力均较术前均有明显提高。 第二部分糖尿病合并白内障超声乳化术后黄斑中心凹视网膜厚度及视网膜敏感度变化 目的：观察糖尿病合并白内障患者在超声乳化吸除术后黄斑中心凹厚度以及视功能变化情况,探讨黄斑结构变化与视功能之间关系。 方法：使用OCT联合MP-1对102例糖尿病合并白内障患者在超声乳化吸除术前、术后1周、术后1月以及术后3月进行检查,观察患者术眼FT、黄斑中心10。范围视网膜MS以及BCVA的变化,分析超声乳化术对糖尿病患者视网膜厚度及视功能的影响。 结果：将第一部分患者作为对照组,糖尿病组患者两个亚组中5年以上亚组术前平均FT为234.9±14.4μm较对照组有显著性差异,P0.05。两个亚组术后1月、术后3月平均FT较术前均有显著增厚,P0.05；两个亚组术后1月平均FT对照组有显著性增厚,P0.05。两个亚组术后1周、术后1月以及术后3月平均MS较术前均有显著提高,P0.05。其中5年以上亚组术后1月平均MS较对照组有显著性差异,P0.05。两个亚组术后1月LogMAR BCVA较术前均有显著降低,P0.05。术后1月发生白内障术后人工晶体眼黄斑囊样水肿(PseudophakicCystoid Macular Edema, PCME)患者共5例,其中5年以上病程组4例。 结论：对糖尿病合并白内障患者,超声乳化手术导致PCME的可能性较大,且可能会导致视功能下降,且病程较长患者影响较病程较短患者更明显,术后视功能恢复所需时间更长。 第三部分高度近视合并白内障超声乳化术后黄斑中心凹视网膜厚度及视网膜敏感度变化 目的：光学相干断层扫描(Optical Coherence Tomography, OCT)联合微视野MP-1仪检测单纯老年性白内障患者、糖尿病及高度近视合并白内障患者在超声乳化吸除术后黄斑结构变化,并探与视功能的关系。 方法：67例高近合并白内障患者在超声乳化吸除术前、术后1周、术后1月以及术后3月进行检查进行OCT以及MP-1微视野计检查,观察患者术眼FT、黄斑中心10°范围视网膜MS以及BCVA的变化,分析超声乳化术对高度近视患者视网膜厚度及视功能的影响。 结果：将第一部分患者作为对照组,66例高近合并白内障患者OCT检查手术前平均FT为211.7±13.9μm,较对照组显著变薄,P0.05；术后1月为250.8±31.0μm,术后3月为229.4±22.6μm,术后1月平均FT较术前有显著性差异,P0.05。MP-1检测术前平均MS为6.6±2.5dB,较对照组显著下降,P0.05；术后1月为13.4±3.7dB,术后3月为13.3±3.5dB,均较术前有显著提高,P0.05。术前BCVA≤0.3的患者有64例,术前平均logMAR BCVA为0.67±0.35,术后1月时BCVA在0.4～0.6患者24例,≥0.7的患者41例,术后1月为0.15±0.20,术后3月为0.17±0.15,术后各时间段较术前均有显著性差异P0.05。术后1月经OCT诊断PCME患者有3人。 结论：高度近视黄斑中心凹厚度较对照组显著更薄,术后发生黄斑厚度增加可能性亦较对照组大,同时伴视功能下降。
[Abstract]:Part I Changes of macular foveal retinal thickness and retinal sensitivity after phacoemulsification in senile cataract
Objective: To observe the macular fovea thickness and visual function in senile cataract patients after phacoemulsification, and to explore the relationship between macular structure and visual function.
Methods: Optical Coherence Tomography (OCT) combined with microperimetry-1 (MP-1) was used to examine the foveal thickness (FT) of 128 cases of senile cataract before, 1 week, 1 month and 3 months after phacoemulsification. Mean Sensitivity (MS) and Best Corrected Visual Acuity (BCVA) were measured in the 10 degree range of macular center.
Results: The mean FT of 128 patients with simple senile cataract before OCT was 231.7 65507 There were 51 patients with BCVA 0.3 before operation and 77 patients with BCVA 0.4-0.6 before operation. The average LogMAR BCVA was 0.43.22 before operation, 20 patients with BCVA 0.4-0.6 at 1 month after operation, 108 patients with BCVA >0.7 at 1 month after operation. The average LogMAR BCVA was 0.11.13 at 1 month after operation. There was a significant difference compared with that before operation (P 0.05).
Conclusion: Phacoemulsification combined with intraocular lens implantation has little effect on the fundus of senile cataract patients. The postoperative retinal light sensitivity and the best corrected visual acuity are significantly improved.
Part 2 Changes of macular foveal retinal thickness and retinal sensitivity after phacoemulsification in diabetes mellitus with cataract
Objective: To observe the macular fovea thickness and visual function in patients with diabetes mellitus complicated with cataract after phacoemulsification.
Methods: 102 patients with diabetes mellitus complicated with cataract were examined by OCT combined with MP-1 before phacoemulsification, one week, one month and three months after phacoemulsification. The changes of FT, retinal MS and BCVA in the 10.range of macular center were observed, and the effects of phacoemulsification on retinal thickness and visual function were analyzed.
Results: The average FT of the two subgroups was 234.9 65 The mean MS of the two subgroups at 1 week, 1 month and 3 months after surgery was significantly higher than that before surgery (P 0.05). The mean MS of the subgroups above 5 years after surgery was significantly different from that of the control group (P 0.05). Pseudophakic Cystoid Macular Edema (PCME) was found in 5 patients, including 4 patients with a course of more than 5 years.
Conclusion: For diabetic patients with cataract, phacoemulsification is more likely to lead to PCME, and may lead to visual impairment, and patients with longer course of disease affect patients with shorter course of disease is more obvious, postoperative visual function recovery time is longer.
Part 3 Changes of macular foveal retinal thickness and retinal sensitivity after phacoemulsification in high myopia with cataract
Objective: Optical Coherence Tomography (OCT) combined with micro-field MP-1 was used to detect the macular structure and visual function in senile cataract patients, diabetes mellitus and high myopia patients with cataract after phacoemulsification.
Methods: 67 cases of high myopia complicated with cataract were examined by OCT and MP-1 microperimetry before phacoemulsification, one week, one month and three months after phacoemulsification. The changes of FT, retinal MS and BCVA in the 10 degree range of macular center were observed, and the retinal thickness and visual function were analyzed. Influence.
Results: The average FT of 66 patients with high and near cataract was 211.7 B, significantly lower than the control group, P 0.05; 1 month after surgery 13.4 + 3.7 dB, 3 months after surgery 13.3 + 3.5 dB, were significantly higher than preoperative, P 0.05. Preoperative BCVA < 0.3 in 64 patients, preoperative average logMAR BCVA 0.35, 1 month after surgery BCVA 0.4 ~ 0.6 in 24 patients, > 0.7 in 41 patients, 1 month after surgery 0.15 + 0.20, 3 months after surgery 0.17 + 0.15 There was a significant difference between the two groups (P 0.05). Three patients with PCME were diagnosed by OCT one month after operation.
Conclusion: The macular fovea thickness in high myopia is significantly thinner than that in the control group, and the possibility of macular thickness increase after operation is also greater than that in the control group.
【学位授予单位】：复旦大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R779.66
本文编号：2180160
[Abstract]:Part I Changes of macular foveal retinal thickness and retinal sensitivity after phacoemulsification in senile cataract
Objective: To observe the macular fovea thickness and visual function in senile cataract patients after phacoemulsification, and to explore the relationship between macular structure and visual function.
Methods: Optical Coherence Tomography (OCT) combined with microperimetry-1 (MP-1) was used to examine the foveal thickness (FT) of 128 cases of senile cataract before, 1 week, 1 month and 3 months after phacoemulsification. Mean Sensitivity (MS) and Best Corrected Visual Acuity (BCVA) were measured in the 10 degree range of macular center.
Results: The mean FT of 128 patients with simple senile cataract before OCT was 231.7 65507 There were 51 patients with BCVA 0.3 before operation and 77 patients with BCVA 0.4-0.6 before operation. The average LogMAR BCVA was 0.43.22 before operation, 20 patients with BCVA 0.4-0.6 at 1 month after operation, 108 patients with BCVA >0.7 at 1 month after operation. The average LogMAR BCVA was 0.11.13 at 1 month after operation. There was a significant difference compared with that before operation (P 0.05).
Conclusion: Phacoemulsification combined with intraocular lens implantation has little effect on the fundus of senile cataract patients. The postoperative retinal light sensitivity and the best corrected visual acuity are significantly improved.
Part 2 Changes of macular foveal retinal thickness and retinal sensitivity after phacoemulsification in diabetes mellitus with cataract
Objective: To observe the macular fovea thickness and visual function in patients with diabetes mellitus complicated with cataract after phacoemulsification.
Methods: 102 patients with diabetes mellitus complicated with cataract were examined by OCT combined with MP-1 before phacoemulsification, one week, one month and three months after phacoemulsification. The changes of FT, retinal MS and BCVA in the 10.range of macular center were observed, and the effects of phacoemulsification on retinal thickness and visual function were analyzed.
Results: The average FT of the two subgroups was 234.9 65 The mean MS of the two subgroups at 1 week, 1 month and 3 months after surgery was significantly higher than that before surgery (P 0.05). The mean MS of the subgroups above 5 years after surgery was significantly different from that of the control group (P 0.05). Pseudophakic Cystoid Macular Edema (PCME) was found in 5 patients, including 4 patients with a course of more than 5 years.
Conclusion: For diabetic patients with cataract, phacoemulsification is more likely to lead to PCME, and may lead to visual impairment, and patients with longer course of disease affect patients with shorter course of disease is more obvious, postoperative visual function recovery time is longer.
Part 3 Changes of macular foveal retinal thickness and retinal sensitivity after phacoemulsification in high myopia with cataract
Objective: Optical Coherence Tomography (OCT) combined with micro-field MP-1 was used to detect the macular structure and visual function in senile cataract patients, diabetes mellitus and high myopia patients with cataract after phacoemulsification.
Methods: 67 cases of high myopia complicated with cataract were examined by OCT and MP-1 microperimetry before phacoemulsification, one week, one month and three months after phacoemulsification. The changes of FT, retinal MS and BCVA in the 10 degree range of macular center were observed, and the retinal thickness and visual function were analyzed. Influence.
Results: The average FT of 66 patients with high and near cataract was 211.7 B, significantly lower than the control group, P 0.05; 1 month after surgery 13.4 + 3.7 dB, 3 months after surgery 13.3 + 3.5 dB, were significantly higher than preoperative, P 0.05. Preoperative BCVA < 0.3 in 64 patients, preoperative average logMAR BCVA 0.35, 1 month after surgery BCVA 0.4 ~ 0.6 in 24 patients, > 0.7 in 41 patients, 1 month after surgery 0.15 + 0.20, 3 months after surgery 0.17 + 0.15 There was a significant difference between the two groups (P 0.05). Three patients with PCME were diagnosed by OCT one month after operation.
Conclusion: The macular fovea thickness in high myopia is significantly thinner than that in the control group, and the possibility of macular thickness increase after operation is also greater than that in the control group.
【学位授予单位】：复旦大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R779.66
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